Simplistic Solutions to Non-Existent Problems

"Purification rituals of one sort or another go back millennia. Bloodletting, enemas and fasting were regarded as legitimate medical therapies until the early 20th century."

"A subset of the population has always held the belief that some sort of purification exercise is worthwhile, especially when they see celebrities and influencers promoting their own detox regimens."

"People who market this stuff -- naturopaths, homeopaths and alternative practitioners, including some physicians -- rarely mention what specific 'toxins' they're trying to get rid of, and one of the reasons they don't do that is because they can't."

"By virtue of living on the planet we are exposed to all kinds of things, even when we live healthy lifestyles. There's this belief that these things somehow accumulate and that by engaging in rituals -- a fast of some sort, or a coffee enema or taking some kind of herbal remedy -- that you can purge yourself of 'toxins' and allow your kidneys or liver to work better."

"My other worry is that people will sometimes take herbal products or traditional Chinese medications, which themselves can have lead and other metals in them. Occasionally, we see someone who's got a liver injury as a reaction to something they've taken from a herbalist."

Dr. David Juurlink, internal medicine specialist, head, clinical pharmacology and toxicology, Sunnybrook Health Sciences Centre/University of Toronto

"Detox regimes range from total fasts to 'cleansing foods' and often involve the use of vitamins, minerals, diuretics, laxatives or 'colonic irrigation'. Many are 'liquid-based, low-calorie and nutrient poor." 

"[Detox diets] defy the general principles of human physiology as the liver and kidneys are quite efficient in removing both exogenous and endogenous toxins from our body."

2022 Review of Detox New Year craze

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There is scant scientific evidence to support "detox" diets for toxin elimination. Juice fasts or water diets can have the effect of weight loss in the short term in response to severe caloric restriction but they can also be responsible for reactive binge eating that will lead to the shed weight returning, once normal food intake resumes. According to one study there were 3.4 billion views of 69 TikTok videos with the hashtag #detox. Of those videos, over two-thirds urged products be used for cleansing and/or detoxing internal bodily organs.

The very word 'toxin' takes on a nebulous meaning, one that includes pollutants, synthetic chemicals, heavy metals, processed foods and "other potentially harmful products of modern life", concluded a 2015 review of the topic. While traditionally 'toxin' referred specifically to the intake of drugs or alcohol, certainly not detox diets. It's all about marketing. The organic detox products market (teas, juices, shakes, powders, supplements) is projected to reach the market value of $68.53 billion in 2034.

While some  of the few studies on 'detoxification' have led to positive results on weight and fat loss, according to the U.S. National Institute of Health's National Centre for Complementary and Integrative Medicine, the studies happened to be assessed as being of low quality, poorly designed with few participants, and lacking a control group or peer review.

Juices proffered in 'detoxes' or 'cleanses' that bypass pasteurization, or treated to destroy harmful bacteria can have the effect of making people ill. Absorbing large amounts of juices high in oxalate, such as spinach and beets, can increase the risk of kidney complications. Somewhere in the order of six to eight glasses of water a day maintains adequate hydration. Anything taken to excess has its own potential for harm, however. Albeit rarely, people can advance to water intoxication (or water poisoning) and can result in electrolyte imbalance and low blood sodium that can cause swelling in the brain.

According to Dr. Juurlink, doctors who charge  hundreds or thousands for chelation therapy -- a system that flushes heavy metals from the body: "They'll test patients, they'll find high levels of metal in their urine and then they'll propose a course of chelation therapy to help rid the metals." [However most people normally have elevated metals in their urine]: "That doesn't mean these things need to be removed from the body. Once in a while we'll see a bona fide case of lead poisoning" (caused by high exposure to lead through a hobby or occupation); these are cases best dealt with in hospital by a medical toxicologist.

"There are a couple of topics I'm obsessed with. This is one of them. It's absolutely remarkable how enduring the appeal is."

"[Detoxes and cleanses appeal to our intuitive desire for simplistic solutions] It feels like they ought to work."

"[They also play to] fear and outrage. This idea that there are toxins in the environment that we have to be afraid of and get out of our system, and that's why we're feeling sick. [The allure continues to grow] because the marketing always relies on anecdotes."

"The best diet is a healthy diet that's sustainable and works for you. A severe detox or cleanse isn't any of those things."

Professor Timothy Caulfield, faculty of law and School of Public Health, University of Alberta